Hartmann's Reversal: Weighing the Pros and Cons

I had a sigmoid colon rupture due to undiagnosed diverticulitis in August of 2024. I had emergency surgery with a Hartmann's procedure. I spent 6 days in the ICU due to septic peritonitis. It was a huge shock to wake up from all this to realize how badly my life had been in danger and that I now had a colostomy. The recovery was difficult. I developed an abscess in the lower abdominal/pelvic area that was excruciating. It was treated with antibiotics and a pigtail drain I had through my glute for more than 2 weeks. I even had much of my hair fall out. I was 57 years old and had been healthy prior to this, other than endometriosis years ago, which required me to have an ovary removed.
Four months later, right before Christmas, I had a complete bowel obstruction that required another emergency surgery. The recovery wasn't as bad, but again was no walk in the park.
I have adjusted to the colostomy very well. I don't mind it other than the obvious.
I am now scheduled for a reversal in 3 weeks, and I am terrified. Honestly, reading about so many horror stories on this site has made that fear grow - even though I am grateful to know other people's experiences.

My question is, what are the pros and cons of the reversal?

Even if it is a successful procedure with no complications, I'm worried I will come out on the other side with urgency, leakage, etc., and that I'll still have lots of mysterious stomach pain from time to time like I do now (though the current pain has been likened to potentially be nerve pain, my parastomal hernia, or gas).

Is there even such a thing as being “back to normal” after this - especially with all the scar tissue and adhesions?

The jury is still out on "back to normal."

Just think of it as we all do - the new normal.

Pros and cons of reversal have been discussed in great detail on the forum.

Quicker answers are there if you can navigate.

Others will chime in having reversals done recently. So sit tight, get as much input from them as possible.

The members here will give you solid advice. Good luck.

There is no going back to how it was before. Even with a successful reversal, things will never be quite the same.

You've delineated the risks of the reversal very well. Only you can decide if the benefits outweigh the risks for you. Listen to your heart.

I went in for a consult about revision and was told by a young doctor that they thought they could reverse my colostomy. I was shocked, so I requested multiple second opinions from other surgeons (three, in fact) and finally went with the one who had 20 years of experience because she told me that while it seemed possible, she was unsure of the amount of scar tissue actually present in my abdomen, as that could indeed complicate the reversal quite a bit. She has scheduled me for both a pelvic MRI and a PET CT scan, as I have the other complication of cancer possibly returning. If you're worried about the scars from previous surgery, perhaps there are tests that could give your surgeon more information.

If you're handling your stoma OK and don't want to go through more surgery, you can keep your stoma and still live a near-normal life like 100% of the great guys in here. I hope whatever you decide is right for you.

Regards, IGGIE

Words of Encouragement from Ostomy Advocates I Hollister

All sound observations ............

Good luck

~ ~ ~ ~ ~ Jayne ~ ~ ~ ~ ~ ~

Your worries are well-founded and experienced by many…all the responses here are summed up in Jayne's post of …”all sound observations.” It's helpful to review all avenues and especially responses by those who post on this website; at least that was the case for me.

In my experience, a reversal is a very personal decision…it took me a while to make my decision. Initially, and very shortly after surgery (almost 5 years ago), I was told by my surgeon I could be reversed in 6 months….talk about a dangling carrot and a very hungry rabbit! I could hardly wait….time not only heals, but life can throw huge roadblocks, or I like to look at them as….signs. I have an ileostomy, and it's my understanding that reversal of a colostomy is different. Different also explains why it is important to come to our own decisions - we are all very different.

A decision which you have come to based on your own self-judgment (not docs, not friends, not family) will be your best decision. Move forward with a positive attitude with whatever that decision may be….best wishes and a huge hug.

jb

Hi Kayloo. In July 2023, I was gored by a bison, which ripped open my abdomen and tore my colon (among other things). I woke up a week later with a colostomy. After a month in the hospital (due to the wound across my lower abdomen, NOT due to the colostomy), I went home, adjusted, and resumed my usual activities. Early on my journey, I was told it could be reversed. They recommended I wait 9-12 months for everything to heal completely, which I did. The surgery took 8 hours due to all the abdominal scar tissue, but the reversal was completely successful. It took 4-6 weeks before I felt (or imagined) things normalizing. Those early days were challenging - when I felt the need to poop, I had to respond IMMEDIATELY....or there would be messes! It got better with time. My bowel habits (timing, frequency, etc.) are different than before my accident, but as others have said, it's just a new normal. I don't have incontinence, but I still have to act quickly when I feel an urge. I appreciate how difficult the decision is. Good luck in making it, and in the surgery if you choose it.

Wow! I did not know your story. What an experience! I am constantly amazed at the resilience I see around me.

Absolutely ...... an echo of my own words on thoughts about the decision-making process - how true .... Your own decision is the one that is intuitively right having worked through all the balanced pros and cons. For your own thinking is a process worked through - and any subsequent tweaks or amendments are thus fully livable with and workable too.

BW

J

Wow, you're a very lucky lady. I hope you keep well.

Regards, IGGIE

What a horrible experience! Thank you so much for sharing! Take good care!

PatandWinnie

Amazing - What an experience to live through - Amazing ...... and not only did you live to tell the tale but, and here you may be the most amazing person ...... Your Reversal - after all that ......

..... You must be one of the luckiest folks alive - and reversed ...............

May the rest of your life be rewarding and fulfilling .....  

Perhaps over time, even the 'urgency' may become 'less pressing' - I wish you the absolute best!

~ ~ ~ ~ ~ Jayne ~ ~ ~ ~ ~